Episode 008: Schizophrenia with Dr. Cummings: Controversies, Brain Science, Crime, History, Exercise, Successful Treatment

In this episode, Dr. Puder addresses the fascinating realm of schizophrenia with Dr. Cummings, a previous guest in the show. Dr. Cummings is a psychiatrist with a wealth of experience from working at Patton State Hospital in California, one of the biggest forensic hospitals in the world.

David Puder, MD

There are no conflicts of interest for this episode.

• Defining Schizophrenia

  • Swedish survey about misperceptions of the environment found that roughly 50% of the population have had misperceptions that could be considered psychotic in nature.

• The Loss of Brain in Schizophrenia

  • Schizophrenic patients lose 2% of brain mass per year for the first 5 years in the course of illness.

• Living with Schizophrenia and Perception of Reality

• Are Negative Symptoms in Schizophrenia Precipitated by Medications?

• The Pathology, Biology, and Genetics of Schizophrenia

• Cannabis Use and Risk For Schizophrenia

• Counter-arguments Against Robert Whitaker’s “Anatomy of an Epidemic”

  • Emil Kraepelin, and the Early Studies on Schizophrenia

    • The majority of schizophrenic patients during Kraepelin’s observation became vegetative in their 40s.

    • After the advent of antipsychotic medications, schizophrenic patients are able to function until their 70s-80s

  • Gitlin 2001 Neuroleptic Discontinuation Study

    • Exacerbation or relapse was almost universal within 2 years in those who discontinued antipsychotics

• Schizophrenia Prevention in High Risk Population

  • Australian study on children of schizophrenic parents (Yung, 2011)

• Australian Study on Children of Schizophrenic Parents

• Crime, Violence, Mass Shootings and Schizophrenia

• Medical Management of Schizophrenia

• 1st Break Psychosis

• Long-acting Injectable Antipsychotics in Early Illness

• Medication Adherence

• Exercise

  • Exercise for schizophrenia increased hippocampal size by 12% vs. -1% for non-exercising groups of patients (Pajonk, 2010)

• Lifestyle, Diet Optimization 

References

Gitlin, M., Nuechterlein, K., Subotnik, K. L., Ventura, J., Mintz, J., Fogelson, D. L., ... & Aravagiri, M. (2001). Clinical outcome following neuroleptic discontinuation in patients with remitted recent-onset schizophrenia. American Journal of Psychiatry, 158(11), 1835-1842.

Pajonk, F. G., Wobrock, T., Gruber, O., Scherk, H., Berner, D., Kaizl, I., ... & Backens, M. (2010). Hippocampal plasticity in response to exercise in schizophrenia. Archives of general psychiatry, 67(2), 133-143.

Yung, A. R., & Nelson, B. (2011). Young people at ultra high risk for psychosis: research from the PACE clinic. Revista Brasileira de Psiquiatria, 33, s143-s160.